Medical debt has no distinction apart from other accounts once they are outsourced to a collection agency.

It’s a foreign language to many.

The face of medical debt has changed drastically within the past five years. Before the U.S. economy fell apart, most doctors, hospitals and other health institutions carried their own debt.

Combine our weakened economy, high unemployment with the reality of Obamacare and fewer individuals have health insurance than before the recession and Obamacare.

Health care providers can no longer afford to carry their patients’ debt. The providers need ready revenue streams to remain operational. To obtain that money they’re forced to sell their debt to a third-party.

Declining Dollar

Medical debt is different from any other debt the American consumer accumulates. Unlike credit cards, auto loans or home mortgages, Americans don’t fill out credit applications for medical services. (Most hospitals and free-standing out-patient procedure clinics require the patient pay their part before care is provided).

In the recent past, most health-care providers never turned patients over to collections so long as they were making regular payments on their debt.

Today, making payments on a medical bill doesn’t necessarily keep it out of collections. If you’re making small payments, or if you make your payment a few days late when you are under a payment arrangement, you may discover your provider has turned the bill over for collections.

Unfortunately, you may not know there is an unpaid medical bill until you get a call or letter from a collection agency. At this point, it may be too late to avoid damages to your credit. Bills fall through the cracks, are sent to the wrong address, or are sometimes not sent to the patient before they are turned over to collections. This should be illegal, yet it’s not.

The above scenario occurred when my husband received a collection letter from a medical laboratory in Memphis, Tennessee. We’d no idea how the debt had occurred and I called the billing office immediately. My questions: Where was the initial care provided? My husband had never received medical care in Tennessee. I wanted facts. What was the procedure and who’d ordered it? On what date had the procedure been performed? Who had received the results of the procedure and who had authorized the procedure?

I also asked why we hadn’t received notice of the amount before the collection letter—and why hadn’t our insurance companies been billed as we had 100% coverage for the procedure?

Federal law mandates all insurance must be billed and an EoB (Explanation of Benefits) received before an account is turned to a collection agency. Additionally, the patient has thirty days to pay the existing balance after the final EoB has been received by the billing office.

I discovered neither of our insurance companies had been billed for Tom’s lab procedure which had been ordered from his internist office in Little Rock, Arkansas. I was furious! Had the billing office filed with our insurance companies, they would have received payment in full! Instead we were turned to a collection agency and thus the $14.00 amount appeared on our credit report.

I won’t go through the agony or steps I took to remove the account from our credit report. I will say it wasn’t pretty and I used every ounce of my career experience to correct the problem.

Unfortunately, a similar situation occurred two weeks ago when we received a statement that we owed $300.00 for a procedure Tom had at a medical center. Again, I knew the procedure was covered 100% by our insurance but, before I could call the medical center, I needed to pull up Tom’s Medicare Claims Log and research his Blue Cross payments and EoBs. Upon doing so, I discovered both insurance companies paid the appropriate amount and zeroed out the account. The actual problem was that the medical center had billed for the same procedure twice under two different provider names.

I made notes for myself before I called the medical center. Aggravation was certain to appear in my voice. I remembered the individuals who don’t have an intimate knowledge of medical bills and reminded myself if I could help just one person that was my responsibility.

I called the medical center and gave the requisite account number. Before I could say why I was calling, the voice on the other end of the line said, “Oh, yes. We realized the account was submitted twice and we’ve fixed the problem.” There was no mention of, we’re so sorry we caused you anxiety or we’re sorry we didn’t call and let you know we billed you in error or any other warm fuzzy comment. How easy it would have been for them to give me a one sentence thank you?

There’s a myth about medical collection accounts. Consumers believe once the account is paid-in-full, the account will be removed from their credit report. In reality, the truth is you can go ahead and pay those medical collection accounts if you owe them, but there won’t be much change, if any, to your credit score. The medical debt will remain on your report for seven years and then you’ll more than likely have to prove it’s been paid before it’s removed. It’s not automatically removed.

I removed the faulty information from our credit report but, if I hadn’t had my own resources it would have been an up-hill battle and legal resources in the thousands with no guarantee of a positive out-come.

Medical identity theft (future blog pending) is increasing at an alarming rate. If your medical identity has been stolen, you won’t know you have medical debt until the bills arrive. Normally what happens is the thief doesn’t use your address or any of your care providers. The thief ignores the co-payment amounts and finally the account is turned to collection and you’re left responsible for the amount due.

One of your most valuable assets is your health benefits.

Before you pay for any medical service, other than your co-payment at a physician’s office or for ancillary service, ask for an itemized bill. Medical bills have a high percentage of error. Ask questions about anything you don’t understand.

If you believe you’ve been over-charged for a procedure and that there’s a significant difference between what your insurance paid and what is still due from you under the co-payment portion of your medical bill, go to http://FairHealthConsumer.org. This database provides cost estimates for medical services. Of course, you can always fight a steep bill by hiring a medical advocate who will contest the charges (http://billadvodates.com), but bear in mind you’ll pay between $50 to $150 an hour or a percentage of your savings.

Fifty-nine percent or nearly 2/3rd’s of the people who experienced medical debt were assured that they received the care for which they were billed. It may take months before all claims are filed and paid by the insurance company.

It is imperative that you or another responsible individual examine each EOB received for every date of service. I keep a ledger for Tom and myself. I know our insurance covers us 100% but that doesn’t stop every provider from billing us. Medical billing offices are notorious for errors.

Currently Fair Reporting Action allows the consumer reporting agencies to include medical debt on a credit report for up to seven years after the date on which it was reported to be delinquent.

While many attempts have been made to address this legislatively there’s zero relief in sight.

Sadly, Mark Rukavina, executive director of The Access Project asks, “What do you get when you combine a dysfunctional insurance billing system with the flawed scoring algorithms? The answer (could be) $5,000 to $6,000 in additional fees for a home mortgage!”

UNFAIR & SHOCKING NUMBERS

In 2010, 44 million Americans, nearly one-quarter (24%) of American adults under the age of 65, had medical debt being paid off over time.

Nearly three-quarters (69%) of those with medical debt were paying off bills totaling less than $4,000.

Nearly a third (31%) were paying off bills totaling over $4,000 and were insured at the time the care was provided.

We’re in need of a Medical Debt Responsibility Act which would prohibit consumer credit agencies from using paid-off or settled medical debt collections in assessing a consumer’s credit worthiness.

Don’t expect change to come soon. It’s nice to dream but as long as members of Congress can acquire whatever medical care they wish and have all prescriptions along with over the counter medications for free at a military facility, why should members of Congress worry about a Medical Debt Responsibility Act?

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About sheridegrom - From the literary and legislative trenches.

Retired Fed/JAG, 5 yrs. on Capitol Hill. Former book buyer for B&N. Health Care Reform proponent to include Tri Care and Medicare. Actively pursuing legislative change wherein dual retirees are exempt from enrolling in Medicare @ their own discretion without affecting other benefits. Active legislative analyst. Now writing womens' fiction and professional book reviews. Concerned citizen of military drawdown.

Hi Sheri,
My Farmer had a major medical event when we were first married and by the time it was over, we were that 31% with >$4,000 debt while having very good insurance. I carried a 4″ tall 3-ring binder for months trying to juggle all the due dates and payments – that alone felt like a full-time job in addition to my 40 hours off-farm, plus farm, plus husband’s small business. Lord have mercy – how did we survive all that – Grace and stubborn refusal to quit helped.

This was about a decade ago, so I wasn’t turned over to any collections agencies. Thankfully, my in-laws stepped in and were able to simply write us a check for the total we owed. They did it as a gift – a gift to our marriage and our sanity and our future. With all the stressors we had on us back then, this financial burden would have struck us very low over time, and I don’t know if our marriage would have survived with this extra hefty weight on it. I can still remember how close to breaking I felt. I’m very grateful for what they were able to do and that they chose to give with no strings attached – the best way for family to help family financially!

I realized many stories don’t have our happy ending. I’m thankful you are here advocating for us. I wouldn’t wish piles of EOB statements and collection calls on anyone.

Emily Grace – I well understand what you mean about ‘the huge notebook that somehow becomes an appendage to your body.’ I wouldn’t wish that lifestyle on anyone. The interesting thing about having really good insurance like you and your farmer and Tom and myself is that we still have to be 100% vigilant. We cannot allow a single EOB or statement to go unaccounted for. Debt of any kind can strangle a marriage and eventually kill whatever love was there at the beginning. You and your farmer were fortunate indeed. Sheri

And you’re right to point out – having good insurance does not reduce the need for vigilance with the EOB’s and medical bills. They must all match up. I don’t remember who told me to make sure about that – perhaps my m.i.l. But someone blessed me with that simple insight and taught me how to read excluded expenses, etc. Not unlike your work here in pointing this out to many. Thanks, Sheri!

Sheri, this makes me so glad we have a national health service here in the UK – people will complain about it at times, but the knowledge that I can get medical care without having to worry about insurance or medical bills is something to be really grateful for. I’m sorry for the distress this has caused you on top of the medical difficulties themselves, but you have great strength to deal with these issues and there must be so many others who wouldn’t know where to begin.

Hi, Andrea. Thank you for stopping by. My aggravations are insignificant and more a ‘thorn in the side’ when compared with what others face. My career and staying current with legislative changes allows me to continue to help others that ask and when I have the time. I definitely don’t want socialized medicine and that’s exactly what the United States is going to have if Obamacare remains in place. Medicare is little more than socialized medicine. It wasn’t that way in the beginning but the entire legislative intent has been destroyed by the two Bush Presidents and the administration of President Obama.

Sheri, what a wonderful informative post. I am always comparing receipts and EOBs. Making sure they balance, and there are no “hanging chad.” I don’t want anything looming over my wife’s head after I reach end of retirement. So far I have been fortunate, I only have one medical group that is run by dingbats, but finally I think we have reached an accord. Please take care, be safe. Bill

Bill, I remember reading in past post of yours about your dealings with medical billing and thought of you when I wrote this post. Being the savvy guy you are, I knew you would have them seeing the error of their way in no time at all. It’s simply so darn aggravating in the meantime.
I look at my stack of filing regarding medical EOB’s and shudder. I am however pleased as they all balance out. We’ve all in all been fortunate.
Mental health is the one kicker and it wouldn’t be if Medicare weren’t in the picture. My therapist hasn’t been paid since Feb 2012 and continues to see me anyway. The combination of BC/BS and Tricare paid her 100% before I turned 65 and they would still pay her 100% if Medicare would move over and say they didn’t care. It absolutely makes no sense to me.

Medical bills is one of the biggest stressors facing people in the U.S. & word round. It breaks my heart that people don’t go to doctors just to avoid this, facing insurmountable bills. Unfortunately, I’m in the profession and none of this is new or surprising to me. I wish it were different. Sending you a big hug.

Paulette – I so agree. I read just last evening that one of three prescriptions aren’t filled because the patient doesn’t have the money. Yet, the information I’m reading on ‘Government Executive’ shows no improvement with Obamacare. My problems are insignificant in comparison to what so many face.

The information on ‘Gov. Executives’ showing no improvements is my understanding in reality and from things I read as well. I don’t know what the solution is but some transparency and integrity would go a long way to helping to diffuse the corruption that is driving good doctors out of business and patients to not get all their meds, or the adequate treatment they need.

Your posts are so valuable and helpful, a really good forum to air things realistically. I don’t know that I agree that your problems are insignificant in comparison, as you mentioned. I feel for you and all you’ve gone through/continue to go through and admire how you come here and share. I’d love to sit down with you and have a cup of tea and chat. You’re an engaging wonderful woman who I feel grateful to be connected with.

The same thing happen with my daughter with one medical bill and one of her college student loans. It was a nightmare. She thought she was keeping an eye on the EOB’s like I do to match up the billing with the EOB’s. I learned that years ago. I have found a few mistakes over the years before it got too bad. But now the way the hospitals charge (nickel and dimeing us to death) it is very difficult to stay on top of things. I have a bill now for my yearly physical from the dr so I have to call TriCare (which you know with any insurance companies is “fun” and very frustrating) and find out how they want them to bill it since the code they used is not correct. I have been told numerous times that my yearly physicals are covered 100%. By time I get it straightened out it will be time for my next physical!
I agree with what you said, “We’re in need of a Medical Debt Responsibility Act which would prohibit consumer credit agencies from using paid-off or settled medical debt collections in assessing a consumer’s credit worthiness” we can add student loans to that too.

Patty – One of the first things I always suggest is to have the hospital, doctor’s office or whoever is the provider of care is to unbundle any care they provided. By federal law, you are entitled to receive this explanation. Many hidden fees are located in lab and x-rays. Additional doctor fees come into play when they read and send their reports to the doctor that ordered the reports. Tricare can no longer carve these extra charges out as non-covered charges. They have a contractual obligation to pay their negotiated rate and that leaves the patient without a co-pay. Tricare also must follow the federal guidelines for Medicare and Medicaid and both require the annual wellness check a preventive wellness check and you are right, this is a 100% covered fee.
Tricare is one of the hardest of all insurance groups to talk with and I suggest if you don’t reach a satisfactory conclusion within 60 days of when you first start to fight the way they’ve adjudicated your claim, you bring in your congressman for assistance.

The student loans are another subject all together. Actually they are a burr in my side as congress saw to bail out many loans on the backs of the federal employee retirement system. Needless to say I didn’t take kindly to that situation. After all, my theory is that if I could educate myself for a bachelors & masters without taking out a loan, others can do the same. I not only was married but fulfilling the duties of an officer’s wife (my second marriage and since he didn’t want me to go to school – I had to pay my own way out of my own salary). I worked full time while I went to school and still made it through. I know I sound a little harsh here but I simply don’t believe in student loans. I do believe in hard work and realizing every nickle you have must go to your education or you won’t have one. I still remember those agonizing days of working full time for the government and also working another 36 hour week to go along with it just to keep my tuition paid and pay for other incidentals I couldn’t ignore, such as healthcare.

I’m so against our educated young people entering the world of work saddled with a huge debt that is nearly impossible to manage. I hope I haven’t offended you here.

No, you have not offended me. First let me say thank you for your help with Tri care as always. I should have explained a bit more with my plea against the student loans, we have no problem paying for them, but when we had a problem and while we were working on fixing it, her credit went to an agency, we did get it straightened out but now she has bad credit because of us trying to “fix” the problem caused by the bank. The cost of a college education is outrageous because we are giving too much free education out to young people who are not interested in getting jobs. They are getting a free education to remain on welfare (at least in PA), and not all I know are not repaying, there are many young women who are working, raising a family and paying off the debt. But basically the cost of the dead beats are passed down to people like my daughter who is paying out of her nose, even with the low interest of the loan. I agree that the federal government should not have bailed out anyone especially on the backs of the federal employee retirement system. My daughter knows of one gal who refuses to work, because as long as she doesn’t work she doesn’t have to repay her loans and while she gets the some sort of tax credit, they do not take it from her because it is not income…so she still gets a huge refund and no need to pay back her loans. I can go on and on. The loans were meant to help those who want a college degree be able to afford it but like everything else the government is involved and now it is a big mess and is only going to worse. But no,you can never insult me! You are too dear to me for that. How are you guys doing?

Patty, You and your daughter have every right to be angry. People in AR are educated for free also when they meet certain criteria (on welfare). Students who tell me they don’t have time to work while they go to school haven’t covered all their options, in my opinion. The Baptist College here in Conway has the highest number of students with loans in default and non-graduate to default status plus it’s a small campus. (That’s in the entire US).

That is so sad. Both kids worked while going to school, although I cannot help financially at least I can offer my daughter to stay here at home while she pays off her loans. Our son got his degree while serving in the military and as you know with two deployments more than earned his education. The sad thing both are working in jobs that is not their degree. But on that note both are glad they went and got the college degree.

Patty – It’s wonderful your children recognized the need for a higher education and stuck with it in spite of the road blocks put in their way. I pray the day will come when they are both rewarded with careers in their chosen fields. I was in the same place, working outside of my chosen profession and continuing to obtain more and more education. Like your kids, I felt fortunate to have a job as all federal positions were in a freeze when we returned from Germany in 1980. My Dad always told me to keep going to school every chance I had. He’d tell me, everything can be taken away from you with the exception of your faith, your knowledge and your willingness to work.

Hi Angie – Thanks for commenting. The health industry has become so complicated when it really doesn’t have to be. It’s so easy to pay for services not rendered and for services that should be paid by your insurance company. Additionally, often insurance companies pay for services believing they were provided when in fact, they were not. That’s when we get into the issue of our premiums going up. Even if it’s our insurance company getting stuck with paying the higher fee, that cost will be passed on to us, the consumers.

Medical bills are getting more and more confusing. You are amazing the way you aggressively keep on top of everything. We are finding that less and less is covered by the insurance we have …. things that were always covered are no more. It’s frustrating, upsetting .. and expensive!

Yes, I hear you loud and clear. If you have a choice of insurance companies to select from you might want to compare benefits during your open season and see if another company covers more of your medical needs. No one can automatically assume something is covered simply because it once was. Additionally, as more medications are reaching the generic schedule or even making it to the drug store shelves as over the counter products, that lead to extra out-of-pocket expenses for those who have great pharmaceutical coverage. There’s a lot the consumer has to be aware of these days.
Thanks for stopping in. I always enjoy your comments. And, above all, don’t give up. We must make health care a national priority but I’m not in favor of socialized medicine in any form.

Sheri, I don’t know whether or not this is still part of the problem, since I’ve been retired for several years now, but during my career as a health insurance agent I frequently found that the hospital department handling insurance claims might be 30 to 90 days behind in filing. Meanwhile, the billing department was hounding the patient to death over the bill. I ran into that situation many times over the years.

On a different facet of the problem, I’m glad you examine EoB’s. My experience was that most people would allow providers to soak insurance companies for whatever they could as long as they weren’t personally liable. Too many people think “insurance company money” grows on trees or something. They don’t realize – or don’t care – that it’s premiums that pay those bills. If an insurer pays a false or inflated bill, sooner or later it shows up in increased premiums.

David – You’ve made excellent points here. Financial officers of hospitals now push for faster billing due to the need for a faster turn around on working revenue. In the 80s and even the 90s we frequently saw hospitals lag 90 to 120 days behind in billing. In investigating fraudulent billing, a practice we frequently saw was the hospital would place a insurance company that an account would be forthcoming. By doing the notice, the hospital could be as pokey as they wanted. Legislation finally cut most of those tactics out and it was needed.
Many hospitals, ancillary services and doctors now use outside billing services. I haven’t researched the ratio. My guess is that if an outside agency is involved, there’s fewer mistakes as the agency wants to retain the account – that’s a guess on my part.

Sheri, you always have such helpful information to share in the medical world.
I agree with all you’ve mentioned here, and would like to add a couple more thoughts on the subject.
As you know, I have my own medical billing business, and I see things from the other end of the spectrum as well. You mentioned the high rate of medical billing errors, and are quite right about that. As a patient I’ve been subjected to having my own chart notes and bills corrected many times. It’s appalling, but not uncommon.
One thing many people don’t realize is that often times doctors choose to hire ‘cheaper’ employees to do their medical billing. Unfortunately, this frequently results in the errors you speak of. Understanding the intricacies of the medical world takes training and diligence. That comes with a cost, and if doctors aren’t willing to hire someone who really knows what they are doing it shows. Secondary insurance billing, write-offs, custody issues, Medicare…the list goes on that can be very tricky.
Many patients don’t pay any attention to the EOBs and never realize they’ve overpaid, or been overcharged. As you pointed out so well, it is crucial to track your EOBs. I staple each EOB to every bill I get from my providers to make sure things are accurate.
Regarding providers no longer being able to carry debt long-term for patients making payments, Obamacare has caused such a disaster for many providers it has to trickle down somewhere. The ultimate effects of Obamacare haven’t fully been reach yet. Small to mid-sized providers will be hard pressed to stay in business because of this ‘free care’. (Someone has to pay for the free care -it’s happening in the form of smaller provider payouts, higher deductibles/co-pays/co-insurance for patients, higher premiums for employers-. I know several people who are choosing to pay the fine rather than sign up for plans they don’t want or like compared to the ones they had that have been cancelled under Obamacare.

Denise – I hoped you would weigh in on this subject. I can always tell when a ‘professional’ such as yourself is on the other end of the phone line vs someone that knows nothing about the world of medicine. I recognize I might expect too much at times as I worked with large numbers of physicians and free-standing medical clinics, etc. that billed the government unbelievable amounts for procedures.
I’m with you on the Obamacare and read an alarming article in ‘Time’ magazine just last week that’s guaranteed to send chills down your spine. I’m thinking about extracting some of the numbers from the article to write my own blog.
I also have to revise my blog Medicare letter. My therapist finally received a phone call (surprise) from Medicare telling her she only has to fill out 1 page and it will keep her in the loop for a couple years. I’ll send you more information as I gather it.
Thanks again for weighing in on this important topic.

Sheri, I would say that I am shocked about all of this, but sadly, I am not. On a smaller scale, medical bills, have put me so far under, I am thinking of becoming a deep sea diver. Not to the extent you discuss here, but enough to tell me that any of us can be devastated by all of this.

Thanks for keeping the light burning :)

PS: I don’t mean to speak lightly of what Identity Theft can do to anyone. Yet, I must share my stock remark. “Anyone stupid enough to steal my identity, get’s what they deserve.”

Florence – I’m angry each and every time I read about medical debt putting an honest individual down. Medical cost is something an individual cannot be prepared for. It no longer matters how much an individual has in savings or how good their insurance, the cost of medical care can and will bring us to our knees. Tom and I have been fortunate with the quality of our insurance but we both paid a tough price to hold onto the insurance. I can’t wait to get Prez Obama out of office. Soon, I fear, he’ll cook up a reason to do away with federal retiree’s participating in our ‘costly health insurance.’

You are so right, my friend. I volunteer from time to time to assist someone in straightening out their medical bills into what they actually owe and what is being billed as their patient responsibility. Our insurance becomes more difficult with each passing day and the stealing of an individual’s medical identity is on an uptake that’s truly alarming.

Yes, everyone needs medical care sooner or later. If an individual doesn’t have insurance, more and more doctors are turning them away. Thus, they have the need to come up with insurance. Our government’s attempt to solve this problem is a failure in Obamacare. There’s really no relief in sight for the working family.
Thanks for stopping by. I always appreciate your comments.

Inese – What happened to Tom and I was on a small scale and that I know how to fix things is a big help. I always think about the individual that doesn’t understand the billing process and then a crook comes along and runs up a bill in their name.
If I were to proceed with one recommendation, it would be to keep a ledger (or even write it on a calendar) of every appointment a family member has with a health care provider. This info can be as simple as the family member name, date and time of the appointment and the name of the doctor. When EOB’s arrive, an adult in the household MUST compare each line item on the EOB to actual services received.
The federal government now requires each physician’s office, hospital, etc. to provide the patient a copy of what was the determination of their visit and actually what was done and what is on the horizon for future medical billing. This information will help everyone gain a better understanding of their EOB’s when they arrive in the mailbox.

Sheri it is the best advice ever. When I was going through difficulties in my life I used to keep a short diary, just the things of certain importance. Same here, keeping track of one’s appointments with some short comments would come in handy when things go wrong. Thank you again for this very useful blog post and the comment!

Thanks for the info, Sheri – all can become very important to any one of us at a moments notice – you never know if it will happen to you – no matter how security conscious you are. Medical bills are hard enough to understand without incompetence and identity theft getting into the mix.
Very helpful – as always….

I shake my head at such irresponsible, devil-may-care attitude to billing when it affects a person’s credit. On the other hand, it’s mind boggling that medical theft exists. I can say it’s unfair because not only are you dealing with health issues, you must fight for the right to be billed properly. I had no idea. None. Thank you for this post, Sheri.

Tess – Over the years, in dealing with hundreds of billing offices, I’ve learned they are on the defensive before they even start to explain why something was billed when it was clearly not something the patient would have received as a medical service. It’s enough to make a person go a little bonkers at times just trying to stay even with the billing office and the numerous mistakes they make. I’ve spent many a day within a billing office showing duplicate charges for a single procedure, outrageous expenses for prescription dispensing, and so on.

Tess – Normally the institution, physician or whoever provided the service receives the extra monies. It is darn near impossible to get money back when a service has been over paid (however it’s been known to happen) tee-hee!

Hello, Lilly: This isn’t the stuff of child’s play is it? I often say, “I trust my doctors but their billing staff carries around stupid sticks.” The bottom line is to do anything you can to keep a medical debt from going to collections. It’s one of the toughest to remove from your credit report.

Excellent post the points you expressed are clearly a problem for many and I imagine the double billing happens more often than not and is either double paid or overlooked rather than how you unfortunately were treated I have observed both sides. It would be in my opinion a lack of care or a lack of conscience morally as they got caught. It is after all your bill… I will share the sentiment and say Sheri, I am sorry that happened to you, you certainly deserve better and better things are coming! :) Hugs, Joe

Joe – Thank you for stopping in and your excellent comment. The few times it’s happened to us, I knew how to fight it and that’s because of my 20 years experience in investigating white collar crime. However, once I retired from government, I readily saw a need for advocacy on behalf of patients who didn’t have my experience in sorting through EOBs and determining the exact amount the patient owed. Let’s just say, it’s become another crusade of mine.
Billing clerks are paid poorly and they often aren’t motivated to work accurately. More and more medical billing is being contracted out and that makes a further disconnect with the medical provider, the billing individual and the patient. Sheri

Elaine, this is terrifying. Thank you for bringing it to our attention. Can you suggest specific things we can do to nudge our elected officials down the right path? I like to write them very specific letters.

Unfortunately, the responsibility of medical billing hasn’t reached the highest level of concern with our elected officials. We are in desperate need of a Medical Debt Responsibility Act. I would request provisions for: all insurance resources must be exhausted before a patient is billed, every (or their representative) receive an itemized bill and not one with bundled charges, in the case of someone using stolen medical identity cards – these individuals must be located and charged for their crime. They must also pay restitution. Those are just a few thoughts from the top of my head. Sheri

I have gone through this with myself and my mother. And we wonder why some people just snap. it is dreadfully frustrating, embarrassing, endless. You wrote an excellent post here. I wish I had known all of this five years ago! What a mess.

Kansen – There’s times when I’ve felt the same way and I’m supposed to know what I’m doing! Having investigated insurance companies for not paying the amounts they should have for so many years, I shouldn’t be shocked by anything – but I am. When you have the insurance industry, billing clerks, and possibly a stolen insurance identity working against you, it’s enough to make a person more than a little crazed. We must stand firm and skip the billing clerks and low level insurance clerks and go straight to the top. Sometimes that speeds things along in our favor as they simply want to get rid of us.

I cannot imagine how much time it must take to “fix” this type of problem – hours and hours on the phone, keeping detailed records, etc.. I have a ton of bills from my daughter’s stay in the hospital recently and I have to go through them with a fine-tooth comb now that I’ve read your post.

Patti – I wouldn’t wish your position on anyone. Please make sure all charges on your hospitals billing statement are itemized. You have the right to a copy. You also have the right to know how much your insurance paid on each item. Often an insurance company will bundle payments (labs, x-rays, etc.). You have the right to insist that you want to know each procedure performed and how much your insurance paid for each procedure. We don’t want you paying for more than is rightfully your obligation. Do you still have my phone number. If you need help, by all means give me a call. Don’t stress out over this on your own. I’ve been working on getting my e-mail down to a manageable amount but it’s slow going. If there’s anything at all I can do, please don’t hesitate to contact me. Sheri

Beth – You hit it right on the money. An individual cannot be too vigilant.
Off-subject: How on earth do you manage to comment on every post you follow almost immediately. I’ve held you up as a blogger with the highest of high standards and well – I’ve fallen dreadfully behind. What’s your secret? Sheri

sheri – as to the blogging process, i give to it when i can, and try to respond on a regular basis, i like the give and take of comments, feels more like a conversation. it depends what’s happening in my life at any given time, as far the time commitment. just do what you can, and don’t make yourself more stressed out by adding it to your pile of things you need to do, just do it when you can. we all know you are out there and always look forward to your return.

I’m always happy when I’m afraid what might be a boring blog is well received. I hope you never need the information, but it’s handy to have around. I’ll try to post the blog on Medical Identity Theft next week. Thanks so much for being here. Sheri

Thank you, Elyse. So many individuals are falling into medical debt when they don’t actually owe the bill and that infuriates me to no end. It requires extra work to ensure it doesn’t happen with each visit to your family physician, hospitalization, or other medical event.

For my husband and I, it’s not the insurance that has been the bane of our existence. I set things up so I knew we’d have the best coverage I could possibly get – especially for my husband with a chronic condition by his mid-30s. I knew I had to establish him under my Federal insurance because there was no pre-existing waiting time. Because he had served in the military for 20 years, during the Vietnam era, he was rightfully entitled to Tri-Care for life and the combination of those two insurance companies were to cover both of us for the remainder of our lives.
Then, along came Obamacare and the United States faced socialized medicine in the worst form ever. I pray Congress in 2016 will be successful in turning over Obamacare.
Please keep fighting the system and don’t give up. Most of all, don’t pay for care you didn’t receive. Pull your itemized statements from care providers and compare what your insurance paid and what they didn’t. It’s a long road to victory but I know you can get there!

Cindy – I almost didn’t blog this post. However, all around me individuals are getting ‘took’ by faulty billing systems everywhere. Of course medical providers (including hospitals, independent labs, physical therapy, and on and on) must attempt to make a profit. However, each one has negotiated a cost of what they will accept for payment for each item that is billed. It’s become a racket when medical care providers bill their patients for the paid part by the insurance company and the negotiated rate. This is highly illegal.

I know you are tough and savvy of the world around you and would never allow this type of faulty billing happen to you. However, if a billing office wants to fight someone you know, tell them to get the complete itemized statement and compare it line for line with what the insurance paid. I often follow this up with my insurance company (my way of knowing the margin of increased medical care cost). I rarely have a disputed claim as we are covered 100% but I like to keep my fingers on the pulse of the going rate of cost.

Side note: I have 4 hummers today. I’m rarely up early but for some reason my dog decided it was time for me to roll out of bed. Sure enough, we have 2 hummers in the back near the lavender and 2 in front buzzing through the mister just as fast as they could go. I’m looking out for more.

Wow, Sheri, what an ordeal. I’ve had medical bills that were paid and kept receiving statements on them for months but none were turned over to collections. Some billing issues with various companies once messed up can take forever to get cleared up. This is a great blog to warn and show folks what can happen and how to handle it. Thank you!!!

Levi – Thank you my friend for stopping in. How well I know the situation of having a bill paid in full and still receiving bills. You are so right, it can be absolutely exhausting proving ‘we’re not the bad guy.’ Thankfully you knew what to do to keep your paid accounts out of collection. Sheri

Not in the same league at all, but I spent an annoyingly long time trying to remove an incorrect and small interest payment from my credit card bill. People may have wondered why I was fussing about 10 cents but firstly, it was wrong, and secondly, 10 cents ignored can, in the long run, cause a lot of problems! The issues you raise are very important. I am sorry to hear you have had these matters to deal with. Very frustrating and time consuming. More accountability is definitely required.

Gallivanta – Tom and I are on the lucky end in that we have adequate coverage to cover our medical care 100% at the present time. I well understand what you mean about correcting something while it’s considered ‘insignificant’ by others. White Collar Crime investigations are often built on that very idea. Often the criminal tries something on a small level and then when that works, tries a larger and larger crime until it’s truly significant.